Kenya is banking on a multi-disciplinary approach to cancer treatment and management to offer patients the best treatment outcomes. This is according to, Dr Miriam Mutebi who is the Chairperson of the Kenya Society of Haematology and Oncology (KESHO) and Consultant Breast Surgical Oncologist at the Aga Khan University Hospital. The specialist who is also an Assistant Professor at the Department of Surgery AKU, says the strategy is part of the steps being made by public and private sector players towards offering more personalized and specialized cancer treatment and management. Addressing the bi-annual the three-day, 7th Kenya International Cancer Conference at a Mombasa Hotel, whose theme is improving outcomes for cancer patients: innovations, opportunities and strategies in the care continuum,  Dr Mutebi said even though there has been an increase in the access to the drugs for specific cancer ailments, and to treatment modalities and in financial support for cancer care, many patients still get diagnosed at advanced stages due to financial, health system and sociocultural reason. The multi-disciplinary approach in managing cancer is yielding results in reducing mortalities as well as increasing the success rates in cancer treatments. “In fact, today, how to best tailor treatment to a specific patient is a combined decision by different specialists. Once the decision is made, the patient is involved through a shared decision making process with the oncologists in mapping out the treatment plan that works best for them," she said. The KESHO chairperson noted that currently before any intervention is made, the impact of the specific intervention is considered, vis-à-vis its overall effect on the patient. “Previously, what used to happen in many parts of the country is that one would receive care depending on which cancer specialist one saw first whether or not it was appropriate. Nowadays different specialists are jointly deciding on the best way to treat or manage a specific cancer, thus offering the best wholesome solution,” she said. In keeping with the theme of innovations, with the advent of COVID, we are now seeing more virtual tumour boards which has helped to expand these approaches in settings where specialists are few. Up to 40pc of cancer cases are potentially preventable and all cancers if detected early and treated appropriately have a good overall outcome. However, health insurers do not traditionally support screening and diagnosis. KESHO is continuing to lobby to have health insurers play a key role in identifying cancer cases during their early stages. “This is through increased screening and diagnostics that could soon be covered by both the NHIF [National Health Insurance Fund] and private health insurance. Currently, most insurance companies including NHIF only cover expenses related to cancer treatment frequently when it is advanced,” Dr Mutebi said. “NHIF is also in the process of reviewing its policy to offer more comprehensive coverage of cancer packages and including diagnostics, as opposed to limiting the number of treatment sessions each patient can access under their medical cover.” This has been made possible through advice offered by KESHO specialists to review treatment packages for optimum results in cancer management and treatment. She regretted that sub-Saharan Africa had recorded half a million cancer deaths and that the trend was pointing towards the number of fatalities rising to a million deaths by 2030. There are however opportunities to shift narratives through leveraging innovations. “We know that we are seeing different patterns of disease so it is important to do local research on our disease patterns and patients’ responses to treatment. What works in other parts of the world. Pragmatic innovations in care delivery, diagnosis and treatments have the potential to translate into better care for our populations,” “We are fortunate to have rich policies around cancer care delivery. We need to think about how we can employ combined multi-sectoral approaches to ensure that the implantation of these policies is translated to better patient care and outcomes. We need the financiers, the economists, the educators, the urban planners etc to work together with clinicians develop strategies to deliver value based (quality and cost effective) care for patients.  The ethos of the conference is to explore how we can work together collaboratively to shift narratives for our patients,” Dr Mutebi concluded.

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